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EAST TEXAS BORDER HEALTH CLINIC NPI 1700134996

NPI Profile

NPI: 1700134996

Provider Name: EAST TEXAS BORDER HEALTH CLINIC

Doing Business As: GENESIS PRIMECARE

Classification: General Practice - 208D00000X

Entity Type: Organization

Address:
502 E RUSK
MARSHALL, TX
ZIP 75670

Phone: (903) 927-3782

EAST TEXAS BORDER HEALTH CLINIC is a general practitioner in Marshall, TX. EAST TEXAS BORDER HEALTH CLINIC NPI is 1700134996. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Genesis Primecare.

The provider's business location address is:

502 E RUSK
MARSHALL, TX
ZIP 75670-408
Phone: (903) 927-3782
Fax: (903) 927-1764

The provider's authorized official is Carla Roadcap .
The authorized official title is Ceo and has the following contact phone number (903) 927-3782.

The enumeration date for this NPI number is 8/21/2012 and was last updated on 4/7/2015.

Map - Location of Practice

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 208D00000X General Practice No
2 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) Yes

What is NPI?
NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 6/10/2015